Episode 20: Lactose Intolerance

Fussy eating

Episode 20: Lactose Intolerance

Lactose is often a quiet offender! Quite often we can feel a bit yuk or bloated by it, without realising it’s lactose! In extreme cases, lactose intolerance  causes urgent trips to the toilet with explosive consequences!!

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Highlights:

  • Lactose Intolerance in Children (00:00.078)

  • Understanding Lactose Intolerantness (02:22.926)

  • Lactose Intolerantness and Its Causes (04:40.814)

  • Lactose Intolerant Diet Options (07:05.934)

  • Lactose Intolerant Children and Milk Options (09:22.67)

  • Lactose Intolerant Milk and A2 Milk (11:41.294)

  • Lactose Intolerant Diarrhea in Toddlers (14:04.43)

Show Notes

Lactose is often a quiet offender! Quite often we can feel a bit yuk or bloated by it, without realising it’s lactose! In extreme cases, lactose intolerance  causes urgent trips to the toilet with explosive consequences!!

In this episode, I we cover:

1. Understanding Lactose Intolerance: What it is, why it happens, and its evolutionary background.

2. Symptoms and Diagnosis: How to identify if you or your child might be Lactose intolerant.

3. Dietary Adjustments: Exploring lactose-free and dairy-free alternatives to ensure you make the best choices for your family's health and taste preferences.

4. Managing Lactose Intolerance in Children: Practical tips for parents navigating lactose intolerance with young ones, including using lactase enzymes and selecting the right milk substitutes.

5. Beyond Lactose: A brief insight into other potential gut irritants, such as fructose and sorbitol, setting the stage for future discussions on managing tricky tummies.

Lactose intolerance doesn't have to limit the joy of eating or the nutritional balance in your child's diet. If you're keen to learn more about nourishing your kids with confidence and ease, especially if dealing with dietary intolerances or allergies, I invite you to head to my website  www.nourishwithkarina.com to find out more

Thanks for tuning in, and see you next time! …

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  • Lactose Intolerance in Children (00:00.078)

    You're listening to the Easy Feed Podcast, episode number 20, Lactose Intolerance. Hi there, I'm Carina Savage and with over 20 years experience feeding children, including my own, I've learnt all the secrets that busy mums need to get their children eating better and actually enjoying healthy foods. So a huge welcome to the Easy Feed Podcast.

     

    Welcome back. It's so good to have you. Today's episode is a little gut geeky, but that's my bag. And I wanted to share a little more about lactose intolerance because lactose intolerance is very, very common. You only need to go to the milk aisle to see the number of lactose free options on the supermarket shelf, in the fridge, and also on the long life milk section.

     

    This is a line of food products that we will see continuing to expand. And the reason for this is that many of us are lactose intolerant, even without realizing. I'm going to go back there. I'm going to go back to the cavemen days again. Sorry, I did that in the last podcast, but just quickly, if we go back to the cavemen days when we were just foraging for food and animals,

     

    We didn't really drink milk past weaning, right? We are the only species that nowadays, when we finish breastfeeding from our mother, we move on to another type of milk, another animal's milk. No other species does that. So really our need for enzymes to break down lactose only needed from an evolutionary perspective.

     

    for the first one to two years when we're actually suckling from our mother, having breast milk and needing to digest the lactose from the breast milk. Past weaning, when we stopped breastfeeding, we really don't have a need to digest lactose unless then we drink another animal's breast milk. Sorry, but that's the truth. And we drink cow's milk, which is cow's breast milk.

     

    Understanding Lactose Intolerantness (02:22.926)

    And then we need the lactose now to digest that. But the reason so many of us are lactose intolerant is because our bodies actually weren't designed to need to digest lactose after the age of two, for example, when we finished breastfeeding. So that's why there is such a high incidence of lactose intolerance. And I think so many people are intolerant to milk and get bloated and can have gassy, windy...

     

    explosive bowel actions when they don't even realise they're lactose intolerant, but it's the actual lactose intolerance causing those gut symptoms. And that's because often we don't have the enzymes to digest the lactose. So we can move out of the caveman days now, but really it's, our bodies are still the same. So

     

    Some of us do have enough enzymes to digest the lactose and those people can drink milk and have normal yogurt and custards and whatnot without any gut issues. But if you or hubby or your children have issues with dairy, chances are it's the lactose. Now, dairy is made up of the carbohydrate, which is the lactose, the protein and fat. So sometimes it's

     

    Well, very often in babies, especially, so babies under one, the protein can be a nition and calcium protein allergy is very, very common. But babies can also get lactose intolerance. And definitely as we get older, so school -aged children and teenagers and adults, if there's a problem with milk, it's mostly going to be the lactose. So how does lactose get digested and absorbed? Well, when we drink milk,

     

    or milk containing foods such as yogurt or custard, it goes into our stomach, it goes into our small intestine, and in our small intestine, in our gut, we have cells. Those cells on the tips of those cells have our enzymes to digest lactose. The enzymes are called lactease. And if on those tips of those cells in our small intestine,

     

    Lactose Intolerantness and Its Causes (04:40.814)

    We don't have enough lactase enzymes to digest the lactose. It doesn't get digested and absorbed into the small intestine. Instead, it stays in the bowel and it passes through into the large intestine. And if it's in too big a quantity in the large intestine, it gets munched on by our gut bugs. For breakfast, lunch and dinner, those gut bugs produce a lot of gas.

     

    So you could feel very bloated. And what also happens is if there's too much lactose in the large bowel, it has what we call an osmotic effect and water is drawn into the large bowel. So it can shoot out as diarrhea or explosive bowel actions. So if you know of anybody that has really explosive, loose, gassy, windy bowel actions, chances are they're lactose intolerant.

     

    Babies can also be a bit lactose intolerant and have really mucousy poos. So, I mean, it can also be caused by other things, but typically in school aged children and adults, if you've got those symptoms, lactose is likely to be a key offender. And that's just because it hasn't been digested and absorbed properly. It's not an allergy. It's just an intolerance. And all you need to do is just pick a different milk. You can choose.

     

    Lactose free milk. Lactose free milk is where they've taken the milk, they've popped the enzyme in to digest the lactose down to glucose and galactose. Everything else is the same. They've just digested the lactose for you so that your gut doesn't have to do it. Other options are dairy free options. So we can go for soy milk or oat milk or almond milk. And they are all lactose free. What's not lactose free?

     

    is goat's milk and sheep's milk that will still have lactose. So if you are lactose intolerant and you move from cow's milk to goat's milk or sheep's milk, they will still contain lactose. And the reason is because again, it's breast milk. It has lactose. Lactose is the primary carbohydrate in any breast milk. So what about other products? Well, we've got lactose free yogurt now that you can definitely find in Plentiful Supply in the supermarket.

     

    Lactose Intolerant Diet Options (07:05.934)

    Again, you've got other options such as coconut yogurt or oat yogurt or almond yogurt or soy yogurt, and they're all naturally lactose free. In terms of cream and ice cream, again, you'll have to choose the lactose free versions of those if you're super sensitive. Now, the average adult that's just a little bit sensitive would typically still tolerate up to

     

    Maybe 10 or 12 grams of lactose, which is up to the equivalent of about a cup of milk a day. Now some definitely won't, some are super, super sensitive. But if you're just a little bit sensitive, then you'll probably just need to swap the milk and you may still get away with yogurt because that has less lactose in it. And the reason the yogurt has less lactose in it is because the probiotics, the bugs in the yogurt, they munt on the lactose. So it's got less lactose in it than cow's milk.

     

    But if you are sensitive, then I would buy lactose free yogurt and also lactose free cream and lactose free ice cream. And just be mindful of cream cheese because that will still contain lactose as will chocolate. If you're not too sensitive, then you may get away with regular chocolate. Otherwise go for dark chocolate. Or again, there's plenty of yummy vegan options out there as well. And the cocoa butter is fine because that's dairy free. You just need to find a vegan dairy free.

     

    There are a couple of dairy foods that are effectively lactose free and can be eaten quite freely on lactose free diet and they are butter and cheese. So butter is lactose free and regular cheese is effectively lactose free as a brie and camembert.

     

    So those cheeses can be eaten freely on a lactose free diet. You don't need to worry about buying the lactose free versions. Really that's a marketing ploy. The tiny minuscule amount of lactose in regular cheese is not enough to cool a lactose containing product. So in managing lactose intolerance, regular butter and regular cheese is absolutely fine. It's the cream cheese is the one that you need to watch out for and other

     

    Lactose Intolerant Children and Milk Options (09:22.67)

    creamy cheeses like ricotta and feta do contain a bit of lactose, but regular block cheddar cheese and butter is absolutely fine. Now, if you say to me, look, my child is lactose intolerant and they don't like the lactose free milk because it actually does taste a little bit sweeter. When you digest the lactose down to glucose and galactose, it actually has a sweeter taste profile. And some kids don't like that. Well,

     

    A few kids don't like that, I should say. So if your child doesn't like it, then either go for a plant -based milk or you can get lactase enzymes. And these are really useful if you're going out and this is great for adults as well. So if you yourself have lactose intolerance, then you can get these lactase enzymes that you get at the chemist. You basically just pop a tablet prior to eating dairy.

     

    And it will help you absorb the lactose better basically. So it just acts to be an enzyme for you in your gut to help digest the lactose. So lactase enzymes are definitely available. I even use them sometimes in babies when I'm working with parents with babies with lactose intolerance, but definitely for adults and children. They can be an effective way to help manage lactose intolerance when you're eating out and

     

    You really want that piece of cheesecake, but you know that it's going to just go straight through you. So that's where those like T's and Z's can be beneficial. Now, as I said at the beginning, lactose intolerance is very different to cow's milk protein allergy. Lactose intolerance is the carbohydrate in the milk. The protein allergy is the protein in the milk. So the protein in the milk is a combination of casein and whey. And the allergy is related to the protein.

     

    not the carbohydrate, which is lactose. So if children have a milk allergy, lactose free milk is not going to cut it. It needs to be a non -milk option. So it needs to be either, well, if they're a baby, then 50 % of the time they'll also react to soy. So then it needs to be a different option. That's where you really need to speak to someone like myself and get some professional advice there. But the protein is, the allergies are very different to...

     

    Lactose Intolerant Milk and A2 Milk (11:41.294)

    lactose intolerance, which is the carbohydrate. A2 milk is a different protein. The lactose is still there. So if you, if you're saying, Karina, I think I've got lactose intolerance, I'm going to buy A2 milk. They've changed the protein slightly. So regular milk is like half A1, half A2 protein and the A2 milk is all A2 protein, but that's the protein. It's not the carbohydrate. So A2 milk is still normal lactose containing milk.

     

    Just to confuse the matter though, they have brought out a two lactose free milk. So you can choose that option if you want. As I said, the lactose free world is going to continue to explode. Number one, because they've now got the ability to digest the lactose a lot easier. And number two, I think people are becoming more aware of what lactose intolerance is and they're realizing how many people are lactose intolerant and therefore the

     

    the need for the lactose free milks are growing because people are realising that it's actually making them feel better. At the end of the day, it's still cow's milk and some people will still have a problem with cow's milk protein. So if you try the lactose free milk and still feel yuck, then just take the area completely and swap to a plant based milk. And sometimes and often doing that, people feel a lot better. Just make sure that you get a calcium fortified plant milk.

     

    And the calcium fortification needs to be roughly 120 milligrams of calcium per 100 meals. That's 120 milligrams of calcium per 100 meals. Now, if we're talking about children with lactose intolerance and tummy issues, there are two other food groups that could be problematic. And high fructose fruits and high sorbitol fruits are those two.

     

    And I'll talk about those in another podcast, but laxative intolerance is one of the biggest causes of wind and runny poo in children. But fructose and sorbitol intolerance can also cause that in children. They're sort of your top three. So I promise I'll do another podcast on that one day and then we'll dive even deeper into, well, probably just as much into the gut geeky side of things as I have today. But laxative intolerance is definitely a great place to start. If you've got a child with

     

    Lactose Intolerant Diarrhea in Toddlers (14:04.43)

    a tricky tummy or if you yourself have a tricky tummy, a wind or explosive poos, bowel actions, I should say, either either really, it's all the same thing. But as I said, sometimes, especially in toddlers, toddler diarrhea can be caused by too much fruit juice, fruit, high fructose fruits, high sorbitol fruit. So as I said, we'll talk about that in another day. Please reach out to me if you do want to know more about that as well, because that's my bag. I love talking about that kind of thing. I would talk about poo all day long.

     

    And also eating of course, but that's my little 101 on lactose intolerance for today. I hope you found that informative. Thanks for listening. Please leave me a review so we can get this podcast out to more moms out there and I'll see you next time. Bye for now.

paediatric dietitian

I'm Karina Savage, and welcome to The Easy Feed Podcast!

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